Understanding Stroke - the Basics

What Is a Stroke?

When the blood supply to the brain is interrupted or blocked for any reason, the consequences are usually drastic. Control over movement, perception, speech, or other mental or bodily functions is impaired, and consciousness itself may be lost. Disruptions of blood circulation to the brain are known as stroke — a disorder that occurs in two basic forms, both potentially life-threatening.

Clots near the brain. About three-quarters of all strokes are due to blockage of the oxygen-rich blood flowing to the brain. Called clot or ischemic strokes, they are triggered by either a thrombus (a stationary clot that forms in a blood vessel) or an embolus (a clot that travels through the bloodstream and becomes lodged in a vessel).

This type of stroke is often preceded by brief transient ischemic attacks, or TIAs — episodes of inadequate blood flow that may produce these symptoms:

• Sudden physical weakness
• An inability to talk
• Double vision
• Dizziness

A TIA usually lasts 15 minutes or less. Because these may be signs of an impending stroke, take them seriously and see your doctor.

With a TIA, circulation and the vital oxygen supply are quickly restored and lasting brain and nerve damage is avoided. With any stroke, however, the interruption of blood flow lasts long enough to kill brain cells, producing irreversible damage.

Bleeding in the brain. The second basic type of stroke is bleeding stroke, or cerebral hemorrhage. It occurs when a brain aneurysm ruptures or when a weakened or inflamed blood vessel in the brain starts to leak. An aneurysm is a pouch that balloons out from a weakened spot on the wall of an artery. As blood flows into the brain, the buildup of pressure may either kill the tissue directly or destroy cells by impeding normal circulation to the affected region. This typically produces an excruciating headache, sometimes followed by loss of consciousness.

In contrast to clot strokes, which are generally survived, massive bleeding strokes are fatal about 80% of the time, while even smaller strokes due to bleeding into the brain cause death about 50% of the time.

Because of improved treatment and greater public awareness of the dangers of high blood pressure, the overall death rate from stroke is declining. Nonetheless, stroke remains the third leading cause of death in the U.S., behind heart disease and cancer. It is also the leading cause of disability and second only to Alzheimer's disease as a cause of dementia.

Recovery from stroke depends on the extent and location of brain damage. Although about 25% of patients die within the first year of having their first stroke, some stroke victims recover fully. But in the vast majority of cases, there is lasting physical or mental disability. Weakened stroke victims are also more vulnerable to infectious diseases such as pneumonia. In addition, depression often follows a stroke; unless treated, it can significantly hinder recovery.